Llorca P M, Wolf M A, Lançon C, Bougerol T
Service Hospitalo-Universitaire de Psychiatrie d'Adultes, C.H.U. Sainte-Marguerite, Marseille.
Encephale. 1993 Sep-Oct;19(5):565-71.
Different drugs have been used as adjuvant to neuroleptics in chronic schizophrenia. Bromocriptine, carbamazepine and cyproheptadine have shown an efficacy added to neuroleptics in schizophrenia. In our study, 24 chronic schizophrenic inpatients considered to be resistant to neuroleptics were treated double blind with the associations haloperidol (40 mg a day)--carbamazepine (400 mg a day), haloperidol (40 mg a day)--bromocriptine (2.5 mg a day), haloperidol (40 mg a day)--cyproheptadine (24 mg a day) and haloperidol (40 mg a day)--placebo. The drugs were given successively, in a randomized succession using a latin square procedure, for four 5-weeks periods. A psychiatric assessment using the Brief Psychiatric Rating Scale (BPRS), the SANS (Scale for Assessment of Negative Symptoms) and the SAPS (Scale for Assessment of Positive Symptoms) occurred every two weeks. Extrapyramidal symptomatology and abnormal movements were assessed using the AIMS (Abnormal Involuntary Movement Scale) and the Simpson-Angus scale. Using an ANOVA, we cannot show any clinical efficacy of any of those three drugs as an adjuvant to haloperidol. The discrepancy between our results and the data of the literature can be linked to the high specificity of our sample (resistance to neuroleptics). We cannot show any specific efficacy of those drugs on positive and negative symptoms, using the sub-factors of the SAPS and SANS.
在慢性精神分裂症的治疗中,不同药物已被用作抗精神病药物的辅助用药。溴隐亭、卡马西平和赛庚啶已显示出在精神分裂症治疗中作为抗精神病药物辅助用药的疗效。在我们的研究中,24名被认为对抗精神病药物耐药的慢性精神分裂症住院患者接受了双盲治疗,分别使用氟哌啶醇(每日40毫克)与卡马西平(每日400毫克)联合、氟哌啶醇(每日40毫克)与溴隐亭(每日2.5毫克)联合、氟哌啶醇(每日40毫克)与赛庚啶(每日24毫克)联合以及氟哌啶醇(每日40毫克)与安慰剂联合。这些药物依次使用拉丁方程序随机给药,为期四个5周疗程。每两周使用简明精神病评定量表(BPRS)、阴性症状评定量表(SANS)和阳性症状评定量表(SAPS)进行一次精神科评估。使用异常不自主运动量表(AIMS)和辛普森 - 安格斯量表评估锥体外系症状和异常运动。通过方差分析,我们未能显示这三种药物中的任何一种作为氟哌啶醇辅助用药的临床疗效。我们的结果与文献数据之间的差异可能与我们样本的高特异性(对抗精神病药物耐药)有关。使用SAPS和SANS的子因素,我们未能显示这些药物对阳性和阴性症状有任何特异性疗效。